Provider Demographics
NPI:1720883606
Name:THOMAS, MELANIE (LSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-0244
Mailing Address - Country:US
Mailing Address - Phone:720-492-9793
Mailing Address - Fax:
Practice Address - Street 1:114 N BOULEVARD ST STE 203
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-3011
Practice Address - Country:US
Practice Address - Phone:720-492-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009926070104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker